Today, email is used to support the communications needs of many different types of organizations, ranging from big businesses to small local schools, and just about every personal communication need imaginable.  In this post, we’ll provide a general overview of the email environment and the factors that make it successful.  In addition, we’ll talk briefly about how email may contribute to the successful treatment of patients with chronic diseases.


The Email Environment

Email has been called the “killer app” in the business community for many different reasons, yet all point to the same realization:  email has changed the way consumers and organizations communicate with one another.   Just ask the United States Postal Service and they’ll quickly tell you how the times have changed.   In a recent statement, the USPS reports, “A significant portion of USPS losses in the past few years has been due to an unprecedented decline in mail volume — down more than 20% since 2007.  The replacement of letter mail and business-transaction mail by electronic alternatives continues to cause downward pressure on mail volume.”1  Email is quick, efficient, targetable, measurable, and provides synergies with other media.

A quick look at industry statistics highlights the prevalence of email communications:

Email is the preferred method of commercial communication by 74% of all online adults.”2 Email has been used by nearly 90% of consumers since 2005.3

Email is a tool used by most Americans today, as demonstrated by the number of email users supported by the major providers:

  • Microsoft webmail properties: 256.2 million users
  • Yahoo: 254.6 million users
  • Google: 91.6 million users
  • AOL webmail properties: 48.9 million users.4

There is little doubt of the importance and capability of email to reach U.S households.  So, what do you need to know to get started in leveraging this communication channel?  Similar to most disciplines, email behaviors have been studied and are becoming well understood by practitioners.  Our research and experience has led Endai to identify 3 fundamental laws to successful email communications, which we will describe below.


Email Must Be Relevant

Many people categorize business to consumer communications as spam.  By definition, “spam is unsolicited bulk email”.  Unsolicited means that the recipient has not granted verifiable permission for the message to be sent. Bulk means that the message is sent as part of a larger collection of messages, all having substantively identical content.”5 Email is not spam, if it is permission-based and of interest to the consumer (patient).  When a consumer “opts-in” to email from your organization and becomes a “subscriber,” they are telling you that they want to hear from you and that your communications are relevant to them.

In marketing circles, it has long been known that relevance is the key to successful advertising initiatives.  Studies by leading email research firms consistently validate this axiom, by finding that relevance is a primary reason indicated for opening emails.  Experienced communications specialists apply the information volunteered by their customers to help raise the relevance of e-communications, increasing open rates and click rates, and ultimately impacting customer behaviors.

At Endai, we work to identify relevance by testing a wide range of subject lines, creative copy, and longitudinal programs, targeted by segments and personalized based on the individual needs of the organization’s customers.


Email Must Be Anticipated

If a consumer expects to receive communications from you, then the likelihood that they will open your email goes up significantly.  The following compiled market research survey data is noteworthy:

“64% of small businesses execs said they decide whether or not to open the (email) newsletter based on who it’s from.”6

“79.1% of online merchants feature the company name prominently in the “from” line of the message”7 to increase open rates.

“55.9% of respondents cited knowing and trusting the sender as the primary reason for opening an email.”8

In the realm of patient care specific to chronic diseases, it is likely that patients will be eager to subscribe to email communications and anxiously anticipate the arrival of communications from their healthcare provider, if they believe that the information will be of value to them.


Email Content Must Be Valuable

In any transaction, there is a “value exchange.”  Consumers will conduct business with you if the cost of doing business is less than or equal to the value they receive in return.  Similarly, if subscribers receive critical information or a special offer from you via email, they will learn that there is value to opening your emails.

The value proposition to patients with chronic diseases has the opportunity to be viewed as having significantly high value.   Patients are likely to value care reminders and communications if they believe these emails will benefit their health in the long term.


Patient Care:  Building Your Email Capability

When a patient or loved one is diagnosed with a chronic disease, they typically conduct extensive research, seek trusted advisors, and over time learn how best to manage their health care needs.  Typically, patients or loved ones “learn” best when they absorb small chapters of information over time.  Different patients have different information needs, based on their level of education and personal backgrounds.  The nature of email is well suited to meet the diverse needs of patients and loved ones with chronic diseases.  By observing how patients interact with email content, and how they choose specific content to examine by clicking on carefully engineered links, health care providers can target an appropriate learning curriculum to each patient to maximize the success of  treatment regimens.

There are many aspects of an email capability that need to be considered before launching a campaign, including:

Your messaging strategy, and how emails will compliment your existing communication

Delivery of emails and the technology platform

Building and maintaining the email address database

Creating a Communications Framework (architecting relevance)

Email design and content

Campaign Management

Can-Spam Compliance

Privacy Laws (including HIPPA)

Metrics to guide your campaigns

Endai is well positioned to support these design elements and more as you seek to meet the needs of chronic disease patients.



  2. Merkle”View From the Digital Inbox 2011″ (2011)
  3. MarketingProfs, “2010 Digital Marketing Fact Book” (Spring Edition, 2010)
  4. April, 2008, USA Today article cited ComScore Media Metrix figures for February, 2008
  6. Bredin Business Information (2007)
  7. Retailer (2007)
  8. Path (2007)